Individual provider Active NPI

Nicki Naddaf, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1144070145
Registry record updated May 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
3016669 Issued in MA
Practice address
801 Massachusetts Ave FL 6
Boston, MA 02118-2605
Phone
(617) 414-5951
Fax
(617) 414-9251
NPI assigned
Mar 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 3016669 MA Primary

Addresses

Primary practice location

801 Massachusetts Ave FL 6
Boston, MA 02118-2605

Mailing address

801 Massachusetts Ave FL 6
Boston, MA 02118-2605
Phone (617) 414-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240715003364 MA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 7911442835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3016669MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nnaddaf242366@direct.bmc.masshiway.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716076800000",
    "number": "1144070145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182605",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE FL 6",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182605",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADDAF",
        "first_name": "NICKI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-05-19",
        "certification_date": "2024-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "3016669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.